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General NPI Number Information
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NPI Number | 1740279330
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Entity Type | Organization
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Legal Business Name | COENANT HEALTH SYSTEM
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 4709 66TH ST
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City | LUBBOCK
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State | TX
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Zip | 79414-4841
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Country | US
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Telephone | 806-725-8400
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Fax | 806-725-8463
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Provider Business Mailing Address
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Address Line | 4709 66TH ST
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City | LUBBOCK
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State | TX
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Zip | 79414-4841
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Country | US
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Telephone | 806-725-8400
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Fax | 806-725-8463
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. SAM MATANI
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Credential |
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Telephone | 806-725-8691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 006945
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License Number State | TX
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